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SF1 - Test 4 > 0 - Clinical Presentations / Anatomical Landmarks > Flashcards

0 - Clinical Presentations / Anatomical Landmarks Flashcards

1
Q

Cubital Fossa

A

Borders:

  1. Plane b/t med. lat. epicondyles of humerus
  2. Brachioradialis
  3. Pronator Teres

Contents:

  1. Biceps Brachii Tendon (T)
  2. Brachial Artery (A)
  3. Median Nerve (N)

Place stethoscope here for blood pressure

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2
Q

Quadrangle Space

A

Borders:

  1. Teres Minor
  2. Long Head Triceps
  3. Teres Major
  4. Neck of Humerus

Contents:

  1. Axillary Nerve
  2. Post. Circumflex Humeral Artery
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3
Q

Triangular Interval

A

Borders:

  1. Teres Major
  2. Long and Lateral Head of Triceps

Contents:

  1. Radial Nerve
  2. Deep Brachial Artery
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4
Q

Anatomical Snuffbox

A

Borders:

  1. Abductor Pollicis Longus Tendon
  2. Extensor Pollicis Brevis Tendon
  3. Extensor Pollicis Longus Tendon

Contents:

  1. Radial Artery
  2. Trapezium
  3. Scaphoid (fracture felt here!)

Important for radial pulse and scaphoid fracture

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5
Q

Wrist Drop

A

Two Possible Causes

  1. Damage to Radial Nerve in radial groove; Fracture of Humerus at mid-shaft
    - - -
  2. Damage to Radial Nerve in Axilla; “Saturday Night Palsy” / Bad Crutches
    - - -

Sensory Loss:

Posterior Arm, Forearm, Half-Hobo Glove Hand Distribution

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6
Q

Pain/Tenderness in Anatomical Snuff Box

FOOSH

A

Scaphoid Fracture

Ischemic Necrosis possible due ot distal distribution of blood supply in 10% of population

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7
Q

Trigger Finger

A

Thickening of Fibrous Digital Sheath

Stenosis of Osseofibrous tunnel

Flexor Digitorum Logus/Superficialis can catch on proximal edge of sheath

High Risk: Frequent Use / Rheumatoid Athritis

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8
Q

Mallet Finger

A

Tear of lateral slips of extensor expansions and unopposed action of long flexors

Hyperflexion of DIP joint

Tip of finger locked in flexion

Sliding into 2nd base w/your hands out in front

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9
Q

Boutonniere Deformity

A

Tear of central tendon of extensory expansions to middle phalanx at PIP Joint

Fancy ass looking fingers, flexed at middle joint

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10
Q

Injury to Superior Trunk (C5-C6)

A

Erb-Duchenne Palsy

Cause: Wide separation b/t head and shoulder

Sign: Waiter’s Tip Position

Nerve Loss:

Suprascapular N.

Musculocutaneous N.

Axillary N.

Motor Loss:

Supination (bicep)

Flexion (bicep)

Lat. Rotation (infraspinatus/teres minor)

Abduction (delt/supraspinatus)

Sensory Loss:

Lateral Cutaneous N. of Forearm

Upper Lateral Arm (Axillary Nerve)

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11
Q

Injury to Inferior Trunk (C8-T1)

A

Klumpke’s Palsy

Cause: Violent Abduction of Arm

Sign: Klumpke’s Claw (passive)

Nerve Loss:

Ulnar Nerve

Medial Part of Median Nerve

Medial Cutaneous Nerve of Arm/Forearm

Motor Loss:

Intrinsic muscles of hand (lumbricals/interossei)

Flex MP, Extend IP

Sensory Loss:

T1 Dermatome - Loss of cutaneous innervation of medial arm and medial forearm

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12
Q

Injury to Long Thoracic Nerve (C5-C7)

A

Injury to Long Thoracic Nerve (C5-C7)

Cause: Radical Masectomy/Knife fight

Sign: Winged Scapula

Nerve Loss: Long Thoracic Nerve

Motor Loss: Abduct arm above horizontal, winged scapula

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13
Q

Injury to Axillary Nerve

A

Injury to Quadrangular Space

Cause: Fracture of surgical neck of humerus, or dislocation of humerus

Sign: Motor/Sensory loss pattern

Nerve Loss: Axillary Nerve (C7)

Motor Loss: Loss of ability to rais arm past 15 deg (supraspinatus)

Sensory Loss: Upper Later Cutaneous N. of arm (police badge)

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14
Q

Damage to Radial Nerve (C7)

  • Damage in AXILLA
A

Saturday Night Palsy

Cause: Prolonged pressure to armpit (crutches, chair)

Sign: Wrist Drop, cutaneous loss of arm, forearm, hand

Nerve Loss: Radial Nerve, Posterior cutaneous, half-hobo-glove

Motor Loss: Tricep Extension, Wrist Extension

Sensory Loss: Arm, Forearm, Half-Hobo-Glove

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15
Q

Damage to Radial Nerve (C7)

  • Damage in HUMERUS
A

Cause: Fracture of Upper Arm

Sign: Wrist Drop, Hand numbness only

Nerve Loss: Radial nerve

Motor Loss: Wrist extension

Sensory Loss: Half-hobo-glove

Triceps NOT damaged, arm/forearm cutaneous NOT damaged

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16
Q

Damage to Median Nerve (C5-C6, C8-T1)

A

Cause: Supracondylar Fracture

Sign: Hand of Benediction

Nerve Loss: Median N., Recurrent Branch of Median Nerve

Motor Loss: Flexors/Pronators of Ant. Forearm, Thenar Muscles–no Opposition of Thumb, Hand of Benediction when patent tries to make fist

Sensory Loss: Reverse-Half-Hobo-Glove, 2/3 Palm

Brachial Artery also a concern

17
Q

Damage to Median Nerve

Pain/Tingling in Distal Fingers, Hand

A

Carpal Tunnel Syndrome

Cause: Compression of median nerve

Sign: Pain/Tingling in finger tips, progressive

Nerve Loss: Median N.

Motor Loss: NA

Sensory Loss: Not full half-hobo glove, finger tips only on dorsal

18
Q

Damage to Ulnar Nerve

  • At Medial Epicondyle
A

Cause: Lesion at Medial Epicondyle

Sign: Weirdo Wave (no flexion of fingers), Ulnar Claw Hand, Can’t grip paper between fingers

Nerve Loss: Ulnar N., Palmar Branch of Ulnar, Dorsal Cutaneous Branch of Ulnar

Motor Loss: Flexion of MP Joints, Extension of PIP and DIP, Adduction-Abbduction of Fingers

Sensory Loss: Palm/Dorsum Fingers 4-5, Forearm

Ulnar Claw hand is PASSIVE

19
Q

Damage to Ulnar Nerve

  • At Wrist
A

Cause: Anything is possible

Sign: Loss of hypothenar, Interosseus and Adductor Pollicis

Nerve Loss: Distal branches of Ulnar, Palmar branch of ulnar

Motor Loss: Adduction/Abduction of hand, Impairment of flexion of MP joints, and extension of PIP and DIP

Sensory Loss: Dorsal Cutaneous NOT lost

20
Q

What can the Shrug Test evaluate?

A

Accessory Nerve (Cranial Nerve XI)

Innervates the Trapezius

21
Q

Most common broken bone in body?

A

Clavicle

22
Q

Ligation of Subclavian Artery

A

Can be made anywhere between Thyrocervical Trunk and Subscapular Artery

23
Q

Dislocation of AC-Joint

A

Separated Shoulder

Acromioclavicular and Coracoclavicular Ligaments torn

Dislocated side elevated due to trapezius - “Step Off Deformity”

24
Q

Dislocation of Glenohumeral Joint

A
  • Violent Abduction, Extension, and External Rotation
  • Head of humerus driven posterior due to weakness of rotator cuff

- Axillary Nerve may be damaged

Final position is Inferior/Anterior

25
Q

Posterior Dislocation of Elbow

A

Ulnar and Radius driven posteriorly

- Humerus driven through weak anterior capsule of joint

  • Ulna may damage Ulnar Nerve
26
Q

Dislocation of Radial Head

A
  • Pulled Elbow/Nursemaid’s Elbow

- Sublacation and dislocation of Radius Head from Anular Ligament

  • Muscle will pull head superiorly following dislocation
27
Q

Colle’s Fracture

A

Distal Fracture of arm bones–“Dinner Fork” Fracture

Ulnar Styloid process can be avulsed, distal fragment of Radius displaced posteriorly

Eat your Colle Slaw with a Fork

28
Q

Boxer’s Fracture

A

Transverse fracture of 5th metacarpal

29
Q

Scapholunate Dissociation

A

Terry Thomas Sign

Increased pain w/dorsiflexion

30
Q

Monteggia Fracture-Dislocation

A

Fracture of Ulna

Anterior dislocation of radius at head, can push into cubital fossa

31
Q

Galeazzi Fracture-Dislocation

A

Fracture of distal 1/3 of radius

Dislocation of distal radioulnar joint

Intact ulna

32
Q

Radial Head Fracture

A

FOOSH–most common in adults

Not always visible, look for posterior fat pad sign, or anterior “sail boat” fat pad sign

33
Q
A

SF1 - Test 4 (9 decks)

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